Medicines adherence with complex medicines regimens – Designing an app that helps
Author: Katherine Burchfield: CEO of NPS MedicineWise
Medicine-related problems in Australia cause around 250,000 hospital admissions and 400,000 emergency department visits every year, costing approx. $1.4 billion, but most of this estimated harm is potentially preventable. Indeed, medicine safety and the quality use of medicines were recently declared the 10th National Health Priority Area by Commonwealth and state and territory health ministers.
The complexity of some medicine regimens (which specify the dosage, schedule and duration of a medicine treatment) is a barrier to adherence and taking medicines correctly, which are key concerns around the quality use of medicines. While taking a medicine every day at the same time is often easier to remember as it can be built into the daily routine, people have told us that complex medicine regimens can be challenging and a tool to keep track of these more difficult cases could help improve adherence and outcomes.
When is a complex regimen a barrier to medicine adherence?
Complexity as a barrier to medicine adherence was highlighted to NPS MedicineWise most recently while speaking with people who have rheumatology conditions.
An example of a complex medicine regimen is the use of the corticosteroid, prednisolone, to treat a rheumatoid arthritis flare. A person may begin with taking 30mg of prednisolone once a day. After 5 days this is reduced to 20mg once a day, then 10mg, 5mg and finally the medicine is stopped, with 5 days between each change. Without a reminder it can be difficult to remember when it is time to change dose and how much to take on a particular day.
Regimens that repeat each week or fortnight or a different period can be hard to get right. For example, to manage rheumatoid arthritis a person may take methotrexate once a week, and on the other days take folic acid. A person taking biological medicines may only take them once every week or two weeks with the dose changing depending on the response to therapy or treatment.
Complex medicine regimens exist across many conditions. Think of, for example, using warfarin to reduce a risk of a clot or using insulin in the management of diabetes.
Extending the functionality of the MedicineWise app
The MedicineWise app is free to use and is funded by the Department of Health. It helps people and their carers keep track of medicines and access important health information relevant to them, anytime and anywhere, especially in emergencies. For the last 7 years, the MedicineWise app has helped over 200,000 people manage their medicines and health, with 45,000+ actively using the app currently.
As part of a program to support the optimal use of biologics and specialised medicines, we have worked with people over the last 9 months to design, develop and test a new functionality of the MedicineWise app called the ‘dose tracker’ that helps people manage complex medicine regimens. This is in direct response to feedback that using an app would help this cohort take the right dose of a medicine at the right time.
This new dose tracker functionality makes the MedicineWise app unique in the Australian market and a powerful tool that enables people who take medicines and their carers to share both simple and complex medicines regimen with pharmacists, doctors and other health professionals. If a person needs to go to hospital, for example, the app will provide valuable information to health professionals in a hospital about a person’s health condition and the medicines they take, to facilitate the best and safest possible care.
Knowledge and data are shaping the future of healthcare
The MedicineWise app is an example of how new technologies are enabling smarter, more personalised healthcare and supporting the quality use of medicines. By having available accurate and up-to-date information about a person’s medicines, unintended medicine interactions and adverse events as well as incorrect dosing become less likely. Ongoing development of the MedicineWise app is one of the ways we are helping people to get the most out of their medicines, safely, and improving outcomes for Australians.